Someone remind me - why keep the breast?

Hi Jenn, I too asked myself the same. Unfortunately I had DCIS in the other side and was going to have both radiated. After a two week research process I made the decision to have BMX. It is not an easy decision and I am nervous but after meeting with the RO, I found myself right where you are. Good luck!

Jenn,

I understand and don't have a good answer for you. All my options were thrown at me in the same appt I found out I had cancer and I had left that appt already agreeing to the lumpectomy/rads without any clear idea what rads were going to be like.   I really should have asked more questions and I WISH I knew about this site then.

There are so many good threads about rads and what helps with the recovery.  I did ok. Hang in there.

Dx 10/2010, IDC, 1cm, Stage IIa, Grade 2, 1/25 nodes, ER+/PR+, HER2-

Hello ladies. Hope you had a great day! 

Just posted this reply to ya in Rads Jenn...Repost it here for you too.

BIG HUGS JENN!! Your post just made me burst into tears...One of those days!!!Can't stop crying but I am right there with ya. That is ONE of my issues today. I feel like a big blubbering BABY! And I should be happy, my last rad was yesterday but I feel the opposite. UGH!!

Healing, comforting Hugs,

Denielle

Jenn, I believe cosmetic and psychological reasons are two of the justifications for keeping a breast, and these are very subjective.



Plus the surgery is less invasive and, if there is no recurrence, there are no follow up surgeries such as would be involved with reconstruction.



As I recall, the survival rates are supposed to be the same with both options but, logically, the local recurrence rate is higher after lumpectomy, but still quite low.



There should be some info in the treatment and side effects menu on this topic. Plus it has been discussed in other threads.



Maybe your question was rhetorical. Only you can decide what is important to you.

Well, you probably won't need reconstruction after lumpectomy. I chose mastectomy and don't regret it (at least not yet--ask me again after reconstruction), because with lumpectomy I would definitely have needed radiation treatment and I was desperately eager to avoid it. I am leaning toward a flap reconstruction, which from all I have heard is a major operation with a long and sometimes very uncomfortable recovery period. There is also some chance that the flap will fail, and generally further surgeries for revision are needed after the original operation to move the tissue flap. With implants, in all likelihood they will need to be replaced after a number of years.

My guess is that you have avoided at least two surgeries (flap transfer + revisions, or TE placement + implant exchange) by choosing the lumpectomy.

I had a BMX (second was prophylactically).  No reconstruction.  I was 58 at the time (turned 61 yesterday).  I did not want radiation therapy and was able to avoid it with the MX.  I also did not want to go through mammo/MRI every 6 months with the accompanying worries, and certainly wanted to try to avoid a new cancer in the other breast.  There is numbness over the surgical scars and small surrounding areas, which is very slowly improving, but I doubt it will ever be completely normal.  No LE, no cording, no pain.  I am very happy with my decision. 

I had a lump & re-excision and neither were able to obtain clear margins, so mx was my only option. I chose bmx & flap reconstruction (yah, recovery is not that fun). I do feel a sense of relief about skipping rads & tamoxifen, and my recurrence risk is much lower even if my survival rate is the same for lump/rads. I simply could not have chosen mx without being forced into it! Some people get lump/rads & live happily ever after. I hope you are one of those lucky gals.

When I was dx'd with DCIS and IDC in my left breast last September, I was offered a lumpectomy with rads.

But my cancer was multifocal, and the surgeon told me that she would have to take such a large wedge of tissue, the breast might be deformed, and I might not be happy with the outcome. She suggested that I think about a UMX.

I did a lot of reading here (I was fortunate to find this site before my surgery), a lot of research, a lot of praying, and a lot of thinking.

The original girls were 38DDD. They were huge, fibrocystic, painful, and droopy. If I had a UMX, I would need a major reconstruction on the remaining right breast. I figured there was no way they'd ever be able to match them up.

Several of my friends had either themselves, or had family members, go through several lumpectomies, only to have a mastectomy later on, wishing they had just done it the first time.

Some friends had very severe reactions to rads. Others had no reaction at all.

Other friends had lumpectomies and rads, and have been NED ever since. They have no regrets and no fears about the future.

My mom had BC, dx'd at the same age I was - 61. She had a radical mastectomy  (and in those days, it WAS radical!) and no other treatment. She passed at the age of 87 from other causes, with no recurrence of cancer.

My radiologist was very concerned that she couldn't tell what was going on in my right breast, and wanted me to have further testing. I thought about carrying around these suspicions for the rest of my life, and suddenly, there I was, considering a BMX.

And that's what I did. I had a very small cancer and I had the maximum surgery, with immediate placement of tissue expanders. The lymph nodes were clear, so no chemo, and all my margins were clear, so no radiation.

 I'm about a month away from my exchange surgery.

Physically, I know it was major surgery. I had a rocky start, especially with the TEs. Not everyone can handle them in their bodies. I was fortunate. I also wanted to try them before I made the decision to go flat. I never considered any of the flap procedures. I think the more work you have done, the more possibilities exist that something can go wrong.

Emotionally, I hated the way my original breasts looked and made me feel. Losing them was not a huge deal for me....getting perky new ones is.

My DH is very supportive of my choice, and agreed that of all my options, I chose the one that made the most sense for me. I didn't keep my nipples, but I do have sensation in the breast skin.

On December 5th, I had a BMX (right one was a prophy - no cancer found) and I have never, ever, regretted my decision.

Tina,



I believe you can have plastic surgery to fix it. Worth looking into.

I'm happy for you Jenn. Once I met with new surgeon and knew I was having BMX, I had a weight lift off my shoulders. I know it will be difficult but there's no easy way out of this. Ha! I too, had extenuating circumstances being I have synchronous BC. I'm thankful I had options. Best wishes!

I have been reading a little about reconstruction after lumpectomy.  My breast drained a lot on Thursday and by the end of the day I actually had a dent in it, which was a concern of mine from the beginning.  I knew the size of my tumor as well as the amount of breast tissue they would have to take, and knew there was a high risk of my breast being deformed after the surgery.  My husband says its fine and doesn't bother him but its bothering me right now.  When I am finished with rad I may look into it but at this point just the thought of another surgery fills me with dread.  On the flip side my left breast was always larger than my right but now they are the same size.  I look for the silver lining in every cloud!

I too was persuaded to go with lumpectomy and radiation.  I finished rads in Jan and the breast looks good.  However, I was completely freaked out about how they would be able to find a recurrence in my very dense breasts.  I was really regretting my choice.  Then it occurred to me that I didn't have to live with my original decision.  I went back to my BS and said I wanted them both removed.  She tried to talk me out of it but said she would support my decision.  My BMX will be on 8/1, no reconstruction.  I do worry about PMPS and other possible problems, but I can't live my life in fear.

I chose to have a mastectomy with lass dors reconstruction oct 09. I do not regret this aithough reconstruction was not great i do not not regret my decision.

 I may be crazy but I did not want any extreme measures to treat my BC. 2 weeks ago I had a lumpechtomy and sentinal node surgery. (Margins and nodes came back neg.) They wanted to do a more extreme lumpectomy because I had calcifications several cm from the invasive cancer. The calcifications were negative and were extracted during stereo biopsy a month before so I saw no reason to remove more of that tissue and everything in between. I saw no reason to be disfigured. The surgeons gave me my way regarding the scope of the surgery. I am happy with my choice.  I'll have radiation to improve my odds against recurrance but I am not sure I am willing to take the Anastrozole the ONC wants to put me on for 5 years. Awful side effects! Why would I want to take something that will weaken my bones and heart? The trade offs are rediculous! I suppose I am a terrible patient but I'll take my chances with the choices I am making.